Key result
In patients with left ventricular hypertrophy, hypertension was the most common etiology (69.7%), while 18.8% had an unknown cause, with Fabry disease and amyloidosis diagnosed in 1.58% and 1.69% of all patients, respectively.
Why the study?
Left ventricular hypertrophy is a common, modifiable cardiovascular risk factor often overlooked in clinical practice, where early diagnosis and treatment-related regression reduce adverse events.
Observational (n=886)
Yes
In patients presenting with left ventricular hypertrophy, nearly 20% have an initially unknown etiology, highlighting the importance of systematic screening for conditions like Fabry disease and cardiac amyloidosis.
Hypertension predominates as LVH etiology in this cohort; leaves open need for prospective studies on demographic predictors before guiding practice.
Purpose: Left ventricular hypertrophy (LVH) is a common condition in the population and potentially modifiable cardiovascular (CV) risk factor often overlooked in clinical practice. Early diagnosis and treatment-related regression of LVH reduces adverse CV events and improves survival. For this reason, we planned to LVH-TR trial to determine the etiological causes of LVH, the symptoms that patients present with, and the effects of demographic characteristics of patients on LVH. Methods: Our study is a multicenter, national, observational study and included 886 patients who applied to the cardiology clinics in 23 centers between February 2020 and August 2021. In the initial evaluation, the Fabry and amyloidosis algorithm was followed in patients whose traditional etiologic cause(s) could not be identified (LVH of unknown origin). Results: The mean age of the patients was 58.92 years, and 60.3% of them were male. More than 90% of the patients were NYHA class I & II patients. The most common etiological causes of LVH in our study were hypertension with a rate of 69.7%, heart valve disease with 10.2%, and hypertrophic cardiomyopathy with 9.2%. Athlete's heart was detected in 8 patients, LV non-compaction was detected in 4 patients.The rate of LVH of unknown cause was 18.8%. Fabry disease was suspected in 143 patients, and Amilodose disease was suspected in 16 patients. There were 43 (4.85%) patients with low α-Galactosidase A enzyme levels in patients who requested enzyme testing. GLA gene mutation analysis was positive in 1.58% of all patients, and these patients were diagnosed with Fabry, and 15 (1.69%) patients were diagnosed with amyloidosis by endomyocardial biopsy method. Conclusion: In the etiology of left ventricular hypertrophy, the rate of LVH of unknown cause was high. Fabry Disease and Amyloidosis should be considered primarily in this patient group. Early diagnosis of the disease by following the schemes leading to Fabry and Amyloidosis was essential in starting treatment before the progression of the disease.
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Kış et al. (2022) conducted an observational in Left Ventricular Hypertrophy (n=886). Left ventricular hypertrophy was evaluated on Etiological causes of left ventricular hypertrophy. In patients with left ventricular hypertrophy, hypertension was the most common etiology (69.7%), while 18.8% had an unknown cause, with Fabry disease and amyloidosis diagnosed in 1.58% and 1.69% of all patients, respectively.
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